The Case:
The patient was a 47-year-old man who complained of blurred vision in the left eye for about one month. His past ophthalmic history was otherwise unremarkable. His past medical history was remarkable for small cell lung cancer diagnosed two years previously for which had been receiving chemotherapy. He said that he had been coughing violently, and he had thrombocytopenia with a platelet count as low as 2000.
The visual acuity was 20/30 OD and 20/400 OS. Anterior segment examination was remarkable for a mild cataract in each eye. Posterior segment examination was remarkable only for the changes visible on the fundus photograph provided.
What was the most likely diagnosis? What treatment, if any, would you recommend?
